Ip M, Teo J G, Cheng A F
Department of Microbiology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin.
J Clin Pathol. 1995 Aug;48(8):775-7. doi: 10.1136/jcp.48.8.775.
Pasteurella multocida is an opportunistic pathogen causing bacteraemia in patients with liver dysfunction. A fulminant case of acute cholecystitis and septicaemia caused by P multocida, complicated by Waterhouse-Friderichsen syndrome without skin haemorrhage, is reported in a previously healthy 64 year old Chinese woman. The patient presented with a six hour history of sudden onset epigastric pain, vomiting, chills, and rigors. A presumptive diagnosis of cholangitis with septicaemic shock was made. Disease progression was rapid and the patient died within eight hours of symptom onset. This case is further proof that skin and mucosal haemorrhages are not an essential feature of Waterhouse-Friderichsen syndrome and this condition should be suspected in all patients presenting with sudden illness and fulminant septicaemia.
多杀性巴氏杆菌是一种可导致肝功能不全患者发生菌血症的机会致病菌。本文报道了一例由多杀性巴氏杆菌引起的急性胆囊炎和败血症的暴发性病例，该病例发生在一名64岁既往健康的中国女性身上，并发了无皮肤出血的华-佛综合征。患者出现突发上腹部疼痛、呕吐、寒战和高热6小时的病史。初步诊断为胆管炎合并感染性休克。疾病进展迅速，患者在症状出现后8小时内死亡。该病例进一步证明皮肤和黏膜出血并非华-佛综合征的必要特征，对于所有突发疾病和暴发性败血症的患者均应怀疑患有此病。
